scholarly journals Surgical Outcomes of Secondary Alveolar Bone Grafting and Extensive Gingivoperiosteoplasty Performed at Mixed Dentition Stage in Unilateral Complete Cleft Lip and Palate

2020 ◽  
Vol 9 (2) ◽  
pp. 576
Author(s):  
Yu-Ying Chu ◽  
Frank Chun-Shin Chang ◽  
Ting-Chen Lu ◽  
Che-Hsiung Lee ◽  
Philip Kuo-Ting Chen
Keyword(s):  
Bone Grafting ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Prospective Trial ◽  
Mixed Dentition ◽  
Alveolar Bone Grafting ◽  
Significant Difference ◽  
Secondary Alveolar Bone Grafting

Secondary alveolar bone grafting (SABG) is associated with donor site morbidities. We aimed to compare the outcomes of SABG and extensive gingivoperiosteoplasty (EGPP) at the mixed dentition stage. This single-blinded, randomized, prospective trial enrolled 50 consecutive patients with unilateral complete cleft lip and palate who had residual alveolar bone cleft, of which 44 (19 SABG, 25 EGPP) completed the study. Bone volumes before surgery, 6 months postoperatively, and 1-year postoperatively were compared using computed tomography. The Bergland scale score was recorded at 6 months postoperatively. Both groups had the same preoperative alveolar cleft volume. On the Bergland scale, 21, 3, and 1 patient in the EGPP group and 16, 2, and 1 patient in the SABG group were classified as types I, II, and IV, respectively, which did not show significant difference. With perioperative orthodontic treatment, the 1-year residual bone defect volume in both groups did not show significant difference (SABG 0.12 cm3 vs. EGPP at 0.14 cm3, p > 0.05). The study was not able to reveal much difference between SABG and EGPP combined with perioperative orthodontic treatment.

Does Early Secondary Alveolar Bone Grafting Influence Need for Additional Maxillary Advancement Procedures in Cleft Lip and Palate?

2021 ◽  
pp. 105566562110427
Author(s):  
Kathlyn K. Powell ◽  
Paul Lewis ◽  
Rae Sesanto ◽  
Peter D. Waite
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Treated Patient ◽  
Tertiary Care ◽  
Mixed Dentition ◽  
Maxillary Advancement ◽  
Alveolar Bone Grafting ◽  
Secondary Alveolar Bone Grafting

Objective To determine if secondary alveolar bone grafting (SABG) timing in patients with cleft lip and palate (CLP) influences the future need for additional maxillary advancement procedures, particularly Le Fort I osteotomy with rigid external distraction (RED). Design Retrospective cohort study. Groups were separated by SABG timing: early mixed dentition (ages 68 years) or late mixed dentition (ages 9-11 years). The criterion for RED was negative overjet ≥8 mm, and sufficient dental development for RED. Setting Single tertiary care institution. Patients Patients with CLP that underwent SABG from 2010 to 2015. Exclusion criteria included syndromic conditions, SABG surgery at age >12 years, current age <12 years, and <2 years follow-up. 104 patients were included. Main outcome measures The number of RED candidates and treated patients. Results There was no statistical difference in the number of RED candidates ( P  =  .0718) nor treated patients ( P  =  .2716) based on SABG timing; stratification by laterality was also insignificant. Early SABG is associated with higher odds of being a RED candidate (pooled, unilateral, bilateral) and treated patient (pooled and unilateral); however, there were no statistically significant associations between SABG timing and the number of RED candidates and treated patients as determined by logistic regression models. Conclusion There is no statistically significant association between SABG timing and the odds of being a RED candidate or treated patient. Future prospective studies are recommended to assess the relationship between SABG timing and maxillary growth in patients with CLP.

Premaxillary Osteotomy and Guided Tissue Regeneration in Secondary Bone Grafting in Children with Bilateral Cleft Lip and Palate

2007 ◽  
Vol 44 (5) ◽  
pp. 469-475 ◽  
Author(s):  
Julia K. Scott ◽  
Roger M. Webb ◽  
Timothy R. Flood
Keyword(s):  
Tissue Regeneration ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Guided Tissue Regeneration ◽  
Mixed Dentition ◽  
Collagen Membrane ◽  
Alveolar Bone Grafting ◽  
Secondary Alveolar Bone Grafting

Objective: To introduce a surgical technique for secondary alveolar bone grafting performed in conjunction with premaxillary osteotomy and guided tissue regeneration in children with bilateral clefts. This paper also looks at the outcomes of this surgery in a series of 15 consecutive patients. Methods: Secondary alveolar bone grafting (with a premaxillary osteotomy and guided tissue regeneration with a collagen membrane) is usually carried out in the mixed dentition stage. This retrospective study used patients’ medical records, radiographs, and clinical examination to assess the outcome of the surgery. Patients were followed up for an average of 3 years. Results: Bone grafting was successful in all cases. No premaxillae were lost and there was no long-term morbidity of the donor site. Radiographic assessment of the bone heights showed an average of 94% retention, 3 months postoperatively. Preliminary assessment of maxillary canine eruption is encouraging, with 79% being fully erupted in those patients who are at least 3 years post–bone grafting. Conclusion: Premaxillary osteotomy allows repositioning of the premaxilla to its optimal preplanned position and successful closure of all fistulae. We have found that use of a collagen membrane is a useful adjunct.

scholarly journals Permanent maxillary central incisor and first molar rotations in the mixed dentition in repaired complete unilateral cleft lip and palate and their relationship with absence of teeth in their vicinity

2018 ◽  
Vol 88 (5) ◽  
pp. 567-574
Author(s):  
Sunjay Suri ◽  
Suteeta Disthaporn ◽  
Bruce Ross ◽  
Bryan Tompson ◽  
Diogenes Baena ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Permanent Tooth ◽  
Mixed Dentition ◽  
Central Incisor ◽  
Maxillary Central Incisor ◽  
Anterior Teeth ◽  
Alveolar Bone Grafting

ABSTRACT Objectives: To describe qualitatively and quantitatively the directions and magnitudes of rotations of permanent maxillary central incisors and first molars in the mixed dentition in repaired complete unilateral cleft lip and palate (UCLP) and study their associations with absence of teeth in their vicinity. Materials and Methods: Dental casts and orthodontic records taken prior to orthodontic preparation for alveolar bone grafting of 74 children with repaired UCLP (53 male, 21 female; aged 8.9 ± 1.0 years) were studied. Directions and magnitudes of permanent maxillary central incisor and first molar rotations were recorded. Tooth absence was confirmed from longitudinal radiographic records. Incisor and molar rotations were analyzed in relation to the absence of teeth in their vicinity. Results: Distolabial rotation of the permanent maxillary central incisor was noted in 77.14% on the cleft side, while distopalatal rotation was noted in 82.19% on the noncleft side. Incisor rotation was greater when a permanent tooth was present distal to the cleft side central incisor, in the greater segment. The permanent maxillary first molar showed mesiopalatal rotation, which was greater on the cleft side and when there was absence of one or more teeth in the buccal segment. Conclusions: Presence and absence of teeth were associated with the severity of incisor and molar rotations in UCLP. Crowding of anterior teeth in the greater segment was associated with a greater magnitude of rotation of the cleft side permanent central incisor. Absence of one or more buccal segment teeth was associated with greater magnitude of rotation of the molar.

Radiographic Assessment of Secondary Autogenous Alveolar Bone Grafting in Cleft Lip and Palate Patients

1997 ◽  
Vol 34 (3) ◽  
pp. 195-198 ◽  
Author(s):  
Jeremy D. Kindelan ◽  
Robert R. Nashed ◽  
Michael R. Bromige
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Kappa Statistic ◽  
Observer Agreement ◽  
Point Scale ◽  
Alveolar Bone Grafting ◽  
Grade 3 ◽  
Secondary Alveolar Bone Grafting

Objective To assess if a 4-point, radiographically based scale could be used between operators to reliably assess the success of secondary alveolar bone grafting. Design The study was retrospective with the clinicians blind to patient identity. Radiographs were examined twice by two clinicians with 1 week between assessments. Setting The research was carried out in a hospital-based orthodontic/oral and maxillofacial unit. Patients All patients who had secondary alveolar bone grafting in this unit between February 1992 and March 1995 were included In this study. There were 38 patients with a total of 48 grafted sites. Interventions The bone graft site was radiographed following orthodontic expansion prior to grafting. The radiograph was repeated postoperatively at a mean of 4 months after surgery. Main Outcome Measure The degree of bony fill in the cleft area was assessed using a 4-point scale: Grade 1 >75% bony fill; Grade 2 50–75% bony fill; Grade 3 < 50% bony fill; Grade 4 no complete bony bridge. Results Overall, 50% of grafts achieved grade 1, 23% were grade 2, 22% grade 3, and 5% grade 4. Levels of intra- and inter-observer agreement were highly variable (.33 to .72 kappa statistic). Conclusions The 4-point scale described could be used to assess the success of autogenous secondary alveolar bone grafting. It showed moderate to substantial intra-observer agreement, and fair-to-moderate inter-observer agreement.

Evaluation of secondary alveolar bone grafting outcomes performed after canine eruption in complete unilateral cleft lip and palate

2016 ◽  
Vol 21 (1) ◽  
pp. 267-273 ◽  
Author(s):  
Diego Coelho Lorenzoni ◽  
Guilherme Janson ◽  
Juliana Cunha Bastos ◽  
Roberta Martinelli Carvalho ◽  
José Carlos Bastos ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Alveolar Bone Grafting ◽  
Secondary Alveolar Bone Grafting

scholarly journals Evaluation of maxillary central incisors on the noncleft and cleft sides in patients with unilateral cleft lip and palate—Part 1: Relationship between root length and orthodontic tooth movement

2017 ◽  
Vol 87 (6) ◽  
pp. 855-862 ◽  
Author(s):  
Aya Maeda-Iino ◽  
Kanako Marutani ◽  
Minami Furukawa ◽  
Shoko Nakagawa ◽  
Sangho Kwon ◽  
...  
Keyword(s):  
Root Length ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Tooth Movement ◽  
Root Apex ◽  
Maxillary Protraction ◽  
Alveolar Bone Grafting ◽  
Secondary Alveolar Bone Grafting

ABSTRACT Objectives: To measure the root lengths of maxillary central incisors (U1) and evaluate the relationship among U1 root length, tooth movement, and type of treatment appliance in patients with unilateral cleft lip and palate over a long-term follow-up period. Materials and Methods: Occlusal radiographs of 30 patients with unilateral cleft lip and palate, acquired less than 6 months before secondary alveolar bone grafting (SBG, T1) and after edgewise treatment (T2), were measured for U1 root length (R1 and R2, root lengths at T1 and T2, respectively). Frontal and lateral cephalometric radiographs acquired at eruption of U1 (T0), T1, and T2 were evaluated to determine the inclination and position of U1. Results: The average values of R1 and R2 on the cleft side were significantly lower than those on the noncleft side. Frontal cephalometric analysis revealed that the horizontal distance of the root apex from the median vertical line at T0 on the cleft side was significantly smaller than that on the noncleft side and was correlated with short U1 root length on the cleft side. On the other hand, R1 in patients treated with maxillary protraction appliances between T0 and T1 was significantly shorter than that in patients without maxillary protraction appliances. However, none of the changes in cephalometric measurements were correlated with root length. Conclusions: In patients with unilateral cleft lip and palate, the short root length of cleft-adjacent central incisors might be associated with the horizontal position of the root apex. In addition, orthodontic treatment with a maxillary protraction appliance before secondary alveolar bone grafting might be associated with short U1 root length.

Sign in / Sign up

Export Citation Format

Share Document